A 9-month-old female infant is brought to the clinic by her parents for a routine well-child evaluation. She was born at 28 weeks of gestation via spontaneous vaginal delivery following preterm labor. Her neonatal intensive care unit stay was prolonged, but she was eventually discharged home in stable condition without oxygen dependence. The parents are highly concerned that she is falling behind her peers in their neighborhood playgroup. They report she cannot crawl, pull herself to a standing position, or pick up small snacks with her thumb and index finger. She has no other significant past medical history. On physical examination, the infant appears well-nourished and interactive. She is able to sit unsupported momentarily but primarily relies on placing her hands in front of her for balance when leaning forward. She successfully transfers a small toy from one hand to the other. When offered a small piece of cereal, she uses a raking motion with all her fingers to grasp it. She babbles single syllables but does not use words meaningfully. When the physician holds the infant in vertical suspension and abruptly lowers her headfirst toward the examination table, she does not extend her arms to break the fall. Which of the following is the most accurate assessment of this patient's developmental status?
- AUpper motor neuron dysfunction suggested by an abnormal postural reflex
- BGlobal developmental delay warranting genetic microarray testing
- Age-appropriate development when adjusted for premature birthAnswer
- DIsolated gross motor delay requiring early intervention physical therapy
- EExpressive language delay necessitating formal audiologic assessment